Q&A: getting a 4-month-old baby to take a bottle

Melissa writes:

"I am currently breastfeeding a 15 week old baby. We would like to give her breastmilk from a bottle, but so far we haven't had a lot of luck with this.

We waited until she was about four weeks before trying and had some luck getting her to drink about an ounce, but we didn't really keep in her "practice". Now she will put the nipple in her mouth but won't suck on it.

We have tried all imaginable bottles and nipples. Some seem to be a little better than others, but none markably so.

I am going to return to work at six months; at the same time I'll be introducing her to solid food. I really don't want to do that sooner and I'd to send her with breastmilk in a bottle.

ANY ideas for helping my baby take a bottle? Brands, technique, persistance, anything?"

Well, I'm 1 for 2. My first child took a bottle easily (on the second try, at 7 weeks) and my second wouldn't take a bottle (we started trying at 2 weeks and gave up trying at 9 weeks) until he was around 5 months or so. And he'll only take one from our babysitter--not from me ("Are you freaking joking me, lady?!" is what his eyes say) and not from my husband ("Nice try, hairy person, but I prefer to wait for the smooth one with the milk") and not from my mom ("I like you so I won't cry very much as you rock me, but I think we can be honest about the fact that both of us hope the lady with the milk shows up soon"). And I think he only takes it from her because he loooves her and is trying to flirt. So I'll tell you what I know, but it may not be any more revelatory than what you've already been doing. Let's hope one of the readers has the magic bullet and will post it.

Here are the basics of what I was told:

* Do not wait until your baby is really hungry to give a bottle. The baby should be interested in the milk, not desperate for it. A hungry baby will become an angry baby, who will reject anything that isn't the norm. Nurse your baby to take the edge off and then try a bottle, or try a bottle an hour or so after your baby has eaten so s/he will be interested but not too hungry.

* Have someone who's not the nursing mother give the bottle. Why would any baby accept milk from a bottle when warm, snuggly, good-smelling mom is right there? Instead, have your partner or someone else give the bottle. Some kids will accept a bottle from someone else when the nursing mother is still there but in another room, but others won't take one if the mother is anywhere in the house. The nursing mother may have to leave (go get a pedicure! or read a magazine all by yourself! or drink a latte!) while someone else gives the bottle.

* Keep it fun. Even though you're desperate for your baby to take a bottle, the baby will be more into it if it's just a fun game. No pressure. Just dripping a little milk onto the baby's lips, then teasing with the bottle to get the baby to try it. Eventually the baby will probably have a lightbulb "Hey! Milk comes out of this thing, too!" moment and the objective will be achieved. We hope.

* Some babies don't want to take a bottle, but will take another kind of cup. Try the Nuby cup or straw cup or sippy cup (with the valve removed, if the baby is under a year or so). Read the comments to this post, which have stellar suggestions from readers about what worked for their kids.

Now that I've regurgitated the same stuff you've heard a million times, I'm going to go a little radical and tell you I think you should not try to make the experience of taking a bottle of breastmilk anything like actually nursing. By the time you go back to work you won't be dealing with a teeny newborn. You'll be dealing with a 6-month-old who will be getting curious and excited about different textures and flavors and experiences. If you can make drinking milk a new and interesting experience that isn't connected to you (since it'll be the daycare provider giving it to her), you might have better luck getting her to take it (since she sounds like one of those babies who doesn't want to be "tricked" into drinking milk from something other than the breast). So it might be worth it to try giving her cold breastmilk out of a straw cup or sippy (or the Nuby if she won't do a straw or sippy). 6 months is kind of a transitional time in a lot of ways, and some kids who are very particular about what goes into their mouths before then get more adventurous for a few weeks right around that time (which makes sense, since that's when kids start to want to eat other foods). You might be able to use that in your favor to get her to drink cold milk out of a different kind of cup.

If you decide to adopt that approach, you might want to wait another month or two before you even try to introduce milk in a cup or sippy. That way you can be closer to the experimentation window and not spend time trying to give warm miilk from a bottle in case you end up giving cold milk from a cup later. But obviously it's your call, based on what makes you feel better about things.

If nothing works, I think you have two options:

1. Let the daycare provider deal with it. Your daughter won't be the first child they've ever dealt with that doesn't want to drink out of a bottle. They probably have tricks we don't know about.

2. Don't worry about it. A 6-month-old can go a long time between feedings, and she may just rearrange her feeding schedule so she eats only solids at daycare and does all her nursing at home. This wouldn't surprise me at all, since I know plenty of babies who are at home with their mothers who hardly nurse at all during the day, but eat food during the day and do most of their nursing in the evening and the 11 o'clock "dream feed." So I think it goes hand in hand with the age of exploration, and is quite a handy way for a baby who doesn't like bottles to still get in enough calories while still not taking a bottle.

Good luck. I think it will end up being much less stressful at 6 months approaches than it is now.

Comments

[Melanie]

Ok, we had such a hard time with this that I literally cried for the whole week before I went back to work (she was 4 months). The onlys thing that worked for us were the following:

• I left every day for 9 (!) days and stayed gone for increasingly longer periods of time, working my way up to 8 hours.

• My DH eventually was the one to get her to take it.

• We looked for a nipple which allowed her to feed in a similar way to how she nurses (ie: face squished up right to the breast). That meant that the only nipple she would take is the Playtex type, since it has a larger, flatter base. Also, my nipples are -ahem- rather brown, so she preferred something of the same shade. *cough*

• Silicone wasn't working, so we switched to old school rubber. She liked that better.

• We held her in a radically different way to when she nurses, and in a position she liked to be carried in - for us that was facing out, and at first she would only bottle feed facing out while walking around the apartment, also while listening to Norah Jones. (Now she practically grabs the bottle out of the fridge herself.)

Once you get her to take the bottle (believe it will happen!), watch out for the following:

• Transitional times were difficult. Sometimes she would refuse bottles and other times the breast. We kept at it and tried not to let our frustration show and she eventually got it.

• As Moxie said, expect her to flip things around a little, to take advantage of the breast. I hate to scare you, but my DD still gets up 1 to 3 times per night, and often feeds hourly in the evening, to fit in as much BFing as possible. She eats more solids with the DCP than she ever has with me and has worked it out so that she only does two bottles per day now. It's not great for my sleep schedule, but it makes her happy.

The most important thing? Try not to stress out. She can do it!

[Amy]

I have nothing brilliant to add, but I do want to add my support. It was one of the hardest things about going back to work. We both freaked out a little during the 3rd month, sure that we had blown it. Like you, we dutifully (if reluctantly) tried the bottle as instructed at about 3 weeks, then basically slacked off for the rest of my 12-wk leave. I was lucky in that starting at 13 weeks, my husband and I were able to spend a month of working half days: he worked in the morning and I worked in the afternoon. Those afternoons were his bottle-learnin' time. For the first week, she wouldn't do it, so she just didn't eat for a 5-hr stretch! This was pretty stressful for my husband. By the second week, she was taking a tiny bit. It improved slowly from there. My husband was patient and would try any technique. He ended up giving her the bottle either on her changing table or in her swing, two places where she was happy and comfortable. Looking back, I'd say it took at least a month of practice to get to where she'd take a couple of ounces at a time.

By the time we started using Grandma for daycare, she was doing fine. YOU are lucky in that your baby will be 6 months old before this really becomes an issue. I agree with Moxie--at that age your baby can get solids mixed with expressed breast milk during the day. You can nurse her frequently before going to work and then as soon as you are reunited at the end of your working day. Maybe your provider can even get her to take a little plain water from a spoon, cup, or bottle.

An aside: I can't tell you how many times I got freaked out by a baby book or breast feeding book that said, with authority, that no infant can thrive on less than x number of feedings a day. My baby went through a period during this transition where she only nursed 4-5 times each day (she was only 4 months old). Luckily my ped's nurse reassured me that babies can and do thrive this way.

Best of luck--I hope you will feel reassured by these comments. It will be fine. It feels desperate, but it will resolve itself.

[Tina]

Also adding my support as a BTDT mom! Both of my children hated the bottle and both of them are now thriving well adjusted very secure children. ... That is my main message -- even if your baby doesn't eat what the books say they should or switches their schedule around or even goes through some times of crying during this transition, rest assured you're an amazing mommy and they are going to thrive and love you so very much.

Now for some tips. You've tried tons of bottles/nipples, another thing to try is different temps - some babies like warmer, some cooler, try different environments. For one of my little ones there could be hardly any distractions, for the other it was just the opposite. Meaning it was best if my hubby had the tv on, was talking on the phone and had our daughter sitting on his lap facing out.

Here's a {hug} too, 'cause I know it is tough!

[Wood]

This was the one issue I freaked out about on a daily basis when my daughter was tiny. I went back to work when she was 4 months old, and from the time she was 2 months until I went back, I tried to give her one bottle a day. this meant finding time to pump, dealing with a pissed baby, and getting really really frustrated. so don't do that. try to relax about it.

in the end, my kid was one of those who never really took a bottle. she was in daycare full time, and over the course of the day, she'd drink a ounce at a time, 3 or 4 times. Yes, for a grand total of 4 oz, or on rare good days, close to 7 oz. We tried the sippy cup several times when she was 6, 7 and 9 months old, but she didn't like that either.

Like Moxie suggested, she didn't nurse that much during the day, and just made up for it at night. Now at almost 13 months, she's still a big nighttime eater and is down to one nursing session during the day (I'm at home now).

anyway -- good luck. You'll figure something out. and getting angry and frustrated doesn't help -- so do your best to relax.

[Anna]

I spent about a month prior to my DD starting daycare freaking out about the bottles (she was 4 months when she started going). She would take one, sort of, then she started refusing the bottle altogether, then she started screaming bloody murder if she even saw the bottle. So I gave up trying and figured I'd drop her off at daycare and wait for the inevitable 'please come pick up the child' phone call.

Guess what? She took the bottle from her DCP with no problems at all from the first day. None. All that worrying for no good reason. Not that I necessarily recommend this approach, but I just wanted to lend some anecdotal evidence to Moxie's 'Let the daycare worry about it' suggestion! Especially if the baby is already eating solids (my daughter wasn't), because then they can mix the BM in with some cereal and at least get something into the baby.

[Julie]

This is really just a variation on several themes that have already been suggested, but here goes anyway.

The instructor for the mom and baby class I took gave me these two ideas when I had a similar problem. In the end, it was just time rather than tricks that worked for us, but I'll offer the ideas anyway in the hope that you'll have better luck:

1. Make bottle/cup feeds as different from nursing as possible -- different location, different person -- any variable you can think to change, try changing it so that these feedings are not connected to nursing in your baby's mind.

2. Do just the opposite, and make nursing and other feedings as alike as possible. This could include the way the baby is held, or even the way the adult giving the feeding holds the bottle. (Our instructor suggested holding it under your arm so that the baby's positioned like she would be to breastfeed.)

FWIW.

[meghan]

I'm so excited that I actually have something to offer, especially on an issue that vexed me greatly!

Cole was totally anti-bottle and after trying everything in the book, on the web, everywhere, I finally got a piece of advice that worked. I wouldn't try this with a baby younger than 4 months old but... try mixing a bottle that is 3:1 water to baby juice. Apple, pear, white grape, whatever. The first reation might be the squished-up 'what in the world is this' face, but the sweetness of the juice makes the bottle seem exciting, I guess.

When Cole was 4 months or so, we got him taking a bottle (playtex, after trying every other brand and spending a fortune) occasionally and a few weeks later used the same trick to get him using a sippy cup instead.

I really hope this helps someone, because it was a godsend for us!

[Carla Hinkle]

My experience was almost EXACTLY like Melanie's (PP above). My daughter got to 4 months and would not take any bottle, and it seemed to be getting worse, not better. Two things finally did the trick:

1. Old-school, brown, rubber, playtex nipples. No idea why but these are what finally worked.

2. Different feeding position -- in our case, a radically different position recommended by a lactation consultant. Take the infant carseat, put baby in. Sit BEHIND the carseat, so baby can't see you at all, and reach around and insert bottle in baby's mouth.

Something about those playtex nipples and the mysterious bottle dropping down from the sky finally worked. It took one afternoon of some fussing (never really crying, just fussing) and she took it. We fed her one bottle a day in the carseat for about a week and then transitioned to the lap.

One other trick is that once you've got something to work (fingers crossed), make sure to do a bottle every day, seven days a week. I think reluctant bottle-drinkers are all too happy to "forget" what they've learned and you don't want to be back at square one again.

Good luck! You'll figure out something that works, even if it is extra daytime food/nighttime nursing.

[cmm]

Thank you so much for addressing this little issue. I have been flummoxed for months as to how to get my 6 month old to eat when I'm not here. Good tips from you and commenters (will run out today and buy a playtex bottle/nipple and some juice). Very reassuring that even if we are not successful he will not starve when he starts day care in a couple months.